RESUMO
Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice.
Assuntos
Antineoplásicos , Neoplasias da Mama , Hipotermia Induzida , Alopecia/induzido quimicamente , Alopecia/prevenção & controle , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Feminino , Humanos , Hipotermia Induzida/métodos , Estudos Prospectivos , Couro CabeludoRESUMO
La alopecia es un efecto generalmente transitorio del tratamiento con citostáticos, generador de una importante repercusión emocional en el tratamiento contra el cáncer, muchas veces responsable de rechazo de distintas maniobras terapéuticas. Si bien en la mayoría de los casos es reversible, esto puede involucrar meses, amplificando el impacto, sobre todo psicológico, de los tratamientos. En los últimos años han surgido estrategias con gorras de frío, o «scalp cooling system» que buscan prevenir, o al menos limitar, este efecto adverso, con resultados que se han mostrado promisorios. El objetivo de esta revisión es analizar la evidencia con la que contamos respecto a los efectos y eficacia de este tipo de técnicas que han empezado a inmiscuirse dentro de nuestra práctica clínica diaria (AU)
Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice (AU)
Assuntos
Humanos , Feminino , Alopecia/induzido quimicamente , Alopecia/prevenção & controle , Antineoplásicos/efeitos adversos , Hipotermia Induzida/métodos , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias da Mama/tratamento farmacológicoRESUMO
Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice (AU)
La alopecia es un efecto generalmente transitorio del tratamiento con citostáticos, generador de una importante repercusión emocional en el tratamiento contra el cáncer, muchas veces responsable de rechazo de distintas maniobras terapéuticas. Si bien en la mayoría de los casos es reversible, esto puede involucrar meses, amplificando el impacto, sobre todo psicológico, de los tratamientos. En los últimos años han surgido estrategias con gorras de frío, o «scalp cooling system» que buscan prevenir, o al menos limitar, este efecto adverso, con resultados que se han mostrado promisorios. El objetivo de esta revisión es analizar la evidencia con la que contamos respecto a los efectos y eficacia de este tipo de técnicas que han empezado a inmiscuirse dentro de nuestra práctica clínica diaria (AU)
Assuntos
Humanos , Feminino , Alopecia/induzido quimicamente , Alopecia/prevenção & controle , Antineoplásicos/efeitos adversos , Hipotermia Induzida/métodos , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias da Mama/tratamento farmacológicoRESUMO
Initial reports suggest that 99mTc-methoxyisobutylisonitrile (MIBI) scanning may be of clinical value in staging patients with malignant melanoma. We carried out a study to evaluate the potential of this technique in the detection of recurrent disease. Whole-body 99mTC-MIBI scans were performed in 81 patients with a history of a surgically excised MM: 28 with known recurrent lesions and 53 during follow-up without evidence of disease. Images started 10 min post-injection, using a dose of 740 MBq. Diagnoses were confirmed by cytological/histological examination or at least one conventional imaging modality. Blinded interpretations of the MIBI scans were performed. Whole-body MIBI scanning correctly detected 68 (92%) of 74 metastatic lesions in the following sites: regional lymph nodes (n=23), non-regional lymph nodes (n=10), skin (n=16), brain/cerebellum (n=6), lung (n=8), bone (n=4) and breast (n=1). The technique failed to detect three subcutaneous regressive lesions (< 1 cm), one liver metastasis, one spleen metastasis and a case of multiple small lesions of the duodenal mucous membrane. In 14 patients the procedure detected previously unknown metastatic lesions. These results suggest that 99mTc-MIBI scanning is an effective imaging modality for whole-body screening of metastatic disease in malignant melanoma patients with the potential to influence treatment planning.
Assuntos
Metástase Linfática/diagnóstico por imagem , Melanoma/diagnóstico por imagem , Melanoma/secundário , Recidiva Local de Neoplasia/diagnóstico por imagem , Radioimunodetecção , Neoplasias Cutâneas/diagnóstico por imagem , Tecnécio Tc 99m Sestamibi , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/secundário , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/secundário , Neoplasias do Sistema Digestório/diagnóstico por imagem , Neoplasias do Sistema Digestório/secundário , Estudos de Avaliação como Assunto , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Neoplasia Residual , Sensibilidade e EspecificidadeRESUMO
A study of early glomerular lesions was made in 8 patients infected with Schistosoma mansoni but having no clinical evidence of renal disease. Electron-microscopy of renal biopsies showed the presence of electron-dense deposits in basement membranes and of laminated bodies near the mesangial cells. Immunofluorescence showed that the deposits corresponded to IgG in 8 cases and to IgM in 2 cases. These lesions are comparable with those found in the kidneys of patients with cirrhosis of the liver.
